Primary hypertrophic osteoarthropathy with bilateral destructive hip arthritis

Younès, M.; Touzi, M.; Béjia, I.; Zrour-Hassen, Saoussen; Amara, Najeh; Hammouda, M. Ben; Bergaoui, N.

doi:10.1016/j.jbspin.2005.11.009

Cited by 9 publications

(10 citation statements)

References 3 publications

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“…The lesions show marked left/right symmetry in paired elements and are solely proliferative; the proliferations evolves in a centripetal fashion (Figure 10); are thickest at the mid‐diaphysis creating an almost cylindrically shaped bone (Figure 7); there are no endosteal changes and, radiographically, the deposits are demarcated from the underlying cortex by a distinct radiolucent line (Figure 11). Hypertrophic lesions themselves are generally of little assistance in indicating the primary disease process, but in this case, the absence of periosteal involvement in the upper extremities predicates against primary HOA, as primary HOA generally exhibits periostosis of the upper extremities as well (Polat & Suma, 1999; Jajić et al , 2001; Ka et al , 2002; Castori et al , 2005; Kabi et al , 2006; Younes et al , 2006; Karkucak et al , 2007; Guarneri et al , 2008). In clinical settings, correlation of radiographic patterns with disease duration have confirmed that thicker, more extensive alterations are indicative of long‐standing disease (Segal & Mackenzie, 1982; Pineda et al , 1987; Pineda, 1992; Martínez‐Lavín et al , 1993).…”

Section: Differential Diagnosesmentioning

confidence: 99%

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy, treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

Christensen

Martı́nez-Lavı́n

Pineda³

2011

Intl J of Osteoarchaeology

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This paper uses macroscopic and radiological examinations to provide differential diagnoses of pathological lesions in the well-preserved skeleton of a young male from the medieval site of Zalavá r in South-West Hungary. Macroscopic inspection of the skeleton revealed conspicuous thickening of the tibiae and fibulae with 'tree bark' appearance of the cortex. Periosteal proliferations are also found on the calcanea and on the posterior part of the femora. The metatarsals showed bony proliferation and bone dissolution. No alteration of the axial skeleton or the skull was noted. Radiographs showed thickening of the cortex of tubular bones due to a multilayered type of periosteal apposition. The likelihood of these symptoms being the result of melorheostosis, hypervitaminosis A, fluorosis, thyroid acropachy, endosteal hyperostosis, tuberculosis (TB), hypertrophic osteoarthropathy (HOA), treponematosis and leprosy is reviewed. None completely explains the entire spectrum of pathological lesions in the current individual, but the individual may have suffered from two coexistent diseases. As a clinical entity, the changes in the metatarsals are compatible with leprosy, whereas the periosteal proliferations of the lower limbs point to a diagnosis of HOA as a secondary syndrome. Thus, a combination of leprosy and TB is suggested as a potential diagnosis. Although not definitive, our differential diagnosis was able to exclude a number of conditions producing periosteal apposition.

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Section: Differential Diagnosesmentioning

confidence: 99%

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy, treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

Christensen

Martı́nez-Lavı́n

Pineda³

2011

Intl J of Osteoarchaeology

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“…PDP is also called Touraine-Solente-Golé syndrome or primary, or idiopathic, hypertrophic osteoarthropathy (HOA). Secondary HOA, as seen in patients with pulmonary or cardiac disease, is much more common, and the primary form accounts for only 3-5% of all HOA cases [5]. The clinical manifestations of PDP may vary.…”

Section: Discussionmentioning

confidence: 99%

Pachydermoperiostosis Mimicking Inflammatory Arthritis: Case Description and Narrative Review

Kamruzzaman

Farzana²,

Sohel

et al. 2023

Rheumato

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Pachydermoperiostosis (PDP), also called primary hypertrophic osteoarthropathy (HOA), is a rare genetic disease with typical thickening of the skin (pachydermia) and rheumatic manifestations, with clubbing of the fingers and toes and periostosis of the long bones visible on X-rays, as well as arthritis in large joints sometimes. Case: We describe a 23-year-old man with a complete form of PDP who presented with polyarthritis of the ankles and knees, with clubbing of the fingers and toes. He was treated with a non-steroidal anti-inflammatory drug (NSAID), etoricoxib, and with bisphosphonates (initially pamidronic acid i.v. and later oral risedronate 35 mg weekly). His joint pains and swelling disappeared, so that he could resume his daily activities. After eight years, the periostosis on the X-rays had disappeared. Discussion: The case is discussed, the literature regarding PDP is summarized and the differential diagnosis and treatment options are reviewed. Conclusions: PDP may present as polyarthritis. Clinicians should be aware of this diagnosis, as treatment is available and may improve the outcome of the patient. It is important to rule out secondary HOA due to pulmonary or cardiac disease, gastrointestinal malignancies and liver cirrhosis, especially when the dermatological findings are not typical. Further, acromegaly, thyroid acropachy and rheumatologic diseases should be excluded.

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“…Such treatments included bisphosphonates (pamidronate, risedronate etc.) [24,33], colchicine, intra-articular steroid injections [30] and synovectomy [26]. Moreover, some of the studies reported their outcome as overall clinical improvement without specifying the particular symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…All 26 studies were case reports which included a total of 54 patients. The studies were conducted in India [16,17,[19][20][21][22], Spain [12,23], Japan [10,21,24,25], Germany [26,27], Italy [14,28,29], Turkey [30][31][32], Brazil [11], Tunisia [33], Portugal [34], Switzerland [35], Poland [35], Czech Republic [35], Australia [35], and UK [13]. One study did not report the study location [7].…”

Section: Flow Of the Review Processmentioning

confidence: 99%

Effectiveness of non-steroidal anti-inflammatory drugs among patients with primary hypertrophic osteoarthropathy: A systematic review

Shakya

Pokhrel²,

Mlunde

et al. 2018

Journal of Dermatological Science

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Primary hypertrophic osteoarthropathy with bilateral destructive hip arthritis

Cited by 9 publications

References 3 publications

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy, treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy, treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

Pachydermoperiostosis Mimicking Inflammatory Arthritis: Case Description and Narrative Review

Effectiveness of non-steroidal anti-inflammatory drugs among patients with primary hypertrophic osteoarthropathy: A systematic review

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